Published online Mar 24, 2016. doi: 10.5500/wjt.v6.i1.174
Peer-review started: June 23, 2015
First decision: August 14, 2015
Revised: November 13, 2015
Accepted: December 1, 2015
Article in press: December 2, 2015
Published online: March 24, 2016
Kidney transplantation is the best available treatment for patients with end stage renal disease. Despite the introduction of effective immunosuppressant drugs, episodes of acute allograft rejection still endanger graft survival. Since efficient treatment of acute rejection is available, rapid diagnosis of this reversible graft injury is essential. For diagnosis of rejection, invasive core needle biopsy of the graft is the “gold-standard”. However, biopsy carries the risk of significant graft injury and is not immediately feasible in patients taking anticoagulants. Therefore, a non-invasive tool assessing the whole organ for specific and fast detection of acute allograft rejection is desirable. We herein review current imaging-based state of the art approaches for non-invasive diagnostics of acute renal transplant rejection. We especially focus on new positron emission tomography-based as well as targeted ultrasound-based methods.
Core tip: Kidney transplantation is the best available treatment for patients with end stage renal disease. For diagnosis of rejection, invasive core needle biopsy of the graft is currently considered as the “gold-standard”. As biopsies carry the risk of significant graft injury, a non-invasive, specific and fast tool screening the whole graft for acute rejection is desirable. We herein review current imaging-based state of the art approaches for non-invasive diagnosis of acute kidney allograft rejection, focussing particularly on new positron emission tomography-based as well as targeted ultrasound-based methods.